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,�.- \'s 6 DALLAS COUNTY HEALTH AND HUMAN SERVICES
0 " - ;) > ENVIRONMENTAL HEALTH DIVISION
c��j�� ,12' M 2377 N. STEMMONS FRWY. ROOM 607
,�, * -1. DALLAS, TEXAS 75207
rf°F�� 214-819-2115 FAX 214-819-2868
i 1-615 CITY/TOWN JjIAJIveJ2SLp7 8 'J -e
San Date Time In Time Out blishment Number Permit Number.. Risk Category•Code ... .., . . _,_ „ _
Purpose of Inspection: 1-Compliance 1, 2-Routine 3-Field Investigation 4-Visit 5-Other
Establishment: C.I17L1E de=„ /� 0 `E Owner: JU$i1iV &4bAJ/(
Physical Address: (/Qto 5ivI0 PLAZA Zip: 75'2}6 Phone: (2A9 265----S-6-72,
OUT IN NA NO COS Food Temperature/Time Requirements
5 Pts Violations Require Immediate Corrective Action Remarks
1." 1. Proper Cooling for Cooked/Prepared Food
,V' 2. Cold Hold(41 degrees Fahrenheit/45 degrees Fahrenheit)
t.,^ 3. Hot Hold (135 degrees Fahrenheit)
L.., 4. Proper Cooking Temperatures
''' 5. Rapid Reheating (165 degrees Fahrenheit in 2 Hrs)
Item/Location/Temperature
OUT IN NA NO COS Personnel/Handling/Source Requirements
4 Pts Violations Require Immediate Corrective Action Remarks
%.., 6. Personnel with Infections Restricted/Excluded
L. . 7. Proper/Adequate Handwashing
i,/ 8. Good Hygienic Practices (Eating/Drinking/Smoking/Other)
v" 9. Approved Source/Labeling
1•." 10. Sound Condition
A✓ 11. Proper Handling of Ready-To-Eat Foods
'i✓' 12. Cross-contamination of Raw/Cooked Foods/Other
`r 13. Approved Systems (HACCP Plans/Time as Public Health Control)
✓ 14. Water Supply - Approved Sources/Sufficient Capacity/Hot and Cold Under Pressure
OUT IN NA NO COS Facility and Equipment Requirements
3 Pts Violations Require Immediate Correction,Not To Exceed 10 Days Remarks
L. 15. Equipment Adequate to Maintain Product Temperature
rA■, 16. Handwash Facilities Adequate and Accessible
V+ 17. Handwash Facilities with Soap and Towels
L/' 18. No Evidence of Insect Contamination
1'' 19. No Evidence of Rodents/Other Animals
_ - 20. Toxic Items Properly Labeled/Stored/Used
e,...-- 21. Manual/Mechanical Warewashing and Sanitizing at{j O)ppm/temperature
i/' 22. Manager Demonstration of Knowledge/Certified Food Manager
V' 23. Approved Sewage/Wastewater Disposal System, Proper Disposal
V' 24. Thermometers Provided/Accurate/Properly Calibrated(±2 degrees Fahrenheit)
V" 25. Food Contact Surfaces of Equipment and Utensils Cleaned/Sanitized/Good Repair
V. 26. Posting of Consumer Advisories (Heimilich/Disclosure/ReminderBuffer Plate)
V 27. Food Establishment Permit
Subtotal Other Violations-Require Corrective Action,Not to Exceed 90 Days or the Next Inspection,Whichever Comes First
5pt
4pt
3pt
0 i Inspected by: �. Print: "G ;
Total i, IR /e
t JiUUr'
F/U Received ' ' I Print: Title:
Yes/No
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